Abstract
Background/Aims Cognitive decline associated with dementia imposes substantial economic and social burden on families and healthcare systems. Cognitive decline may be influenced by chronic disorders (e.g., heart disease, hypertension), through the development of vascular dementia or Alzheimer’s disease (AD). Our goal is to identify specific or clustered chronic conditions impacting transition from normal cognition to cognitively impaired non-dementia (CIND) to dementia, adjusting for demographic and behavioral factors.
Methods This study used data from the Aging Demographic and Memory Study (ADAMS) subsample of the Health and Retirement Survey (HRS). HRS is a nationally representative sample of US non-institutionalized adults. The ADAMS subsample (N = 1770; 70 years or older) was selected from the HRS 2000 or 2002 waves, based on self- or proxy-reported cognition score. Neurological assessments were performed July 2001–December 2003. Two follow-up visits in June 2006–December 2009 assessed changes in cognitive functioning. We analyzed data on 308 persons over three assessment occasions excluding persons diagnosed with dementia at baseline.
Results At baseline, 70% (211) of 308 sample respondents had normal cognition and 31% (97) were CIND. Among respondents with normal cognition, 33% (70) were later diagnosed with CIND and 8% (18) developed dementia, while 44% of those with CIND at baseline developed dementia. Comparing VDW data to these national data, at Scott & White only 4% of persons age 65 or over were diagnosed with dementia in 2010, suggesting a low burden from cognitive decline on this health plan where members are relatively young (US population 13% over age 65 vs. Scott & White 10%). Analysis of trends in cognitive decline by comorbidity, demographics, and lifestyle factors are in progress.
Conclusions At the completion of this project, we will better understand the timing and structure of interventions that could potentially delay cognitive decline and lower associated health care burden.
